Complete this application form after you have selected your health insurance plan.
You will need to have a copy of your Health Insurance Marketplace application nearby to answer some of the questions.
After submitting your application, you will receive an email confirmation and copy of your application. All applications submitted before 12/15 will recieve an approval or denial letter before January 1st.
As of 11/1, Silver Access is not yet contracted with Molina Health, please be aware that Silver Access is not able to confirm third party payment abilities for February premiums.
If you have any questions about the this application or the application process, please email Vanessa Corpus at firstname.lastname@example.org